Some of the figures are climbing at a steady pace: the number of patients, the amount of revenue, the conditions under which people qualify for medical cannabis cards.

Others haven't increased as much: the number of licensed producers, the count of state workers managing the program, the cap on plants for growers (at least not until recently).

But those charts are due for change. New Mexico's 12-year-old Medical Cannabis Program is likely entering a period of resurgence thanks to a friendly administration, a willing Legislature and a booming demand. Health Department Secretary Kathy Kunkel—who wrote the first rules for the program in 2007 as the department's attorney under then-secretary and now-Gov. Michelle Lujan Grisham—says she sees expansion on all fronts.

Last year, a judge ordered the state to raise the limit on the quantity of live cannabis plants each of its licensed producers may keep on hand during the growing process. Lujan Grisham this month signed into law a bill that allows for reciprocity with patients from other states and other door-opening changes to the program. Plus, Kunkel is poised to approve opioid use disorder as a new qualifying condition—one with a probable patient population of epidemic proportions.

"I wrote the original rule," Kunkel tells SFR, "and I am aware of how limited and regulated the program was back then. I am back after 11 years and I am impressed with how much it has already grown and developed. But I think it's on the verge of a significant expansion and growth in many ways."

At its inception, lawmakers called for the Medical Cannabis Program to operate like an enterprise fund, with revenue from fees covering the state's administrative costs. Yet they didn't even allocate independent operating funding for the program until 2012. A graph of revenue growth in the last five years looks like a hockey stick—the department reports that payments from sources such as producer and patient fees, which amounted to $772,000 in 2014, grew to $3.1 million so far in this year.

That's not counting the tens of millions in gross receipts that patients have paid at the dispensary cash register. Patient sales from the 35 licensed producers totaled $105.8 million in 2018, representing a 23% increase over 2017 sales, and patient enrollment grew by 45% over the same time period, says a fiscal impact report by the Legislative Finance Committee.

Yet the staff levels have risen only in fits and starts. The program kicked off with seven full-time staff in 2012, and today has 28 full time workers at offices in Santa Fe and Albuquerque.

"We are understaffed right now for what we do," Kunkel says.

Changes pushed out of the Legislature last month aim to, among other things, eliminate some bureaucratic tasks. Starting in June, more than 70,000 patients won't have to renew licenses each year, but rather every three years, for example. That helps the burdened staff, she says, but not enough. On March 29, the Medical Cannabis Advisory Board issued a recommendation to make opioid use disorder its 23rd qualifying condition. Kunkel says she will adopt it.

"I am not sure what the increase in the population will be but we expect to see, of course, an increase," she says, adding that inter-state reciprocity, which is set to go into effect midway through 2020, also stands to change the regulatory burden. "I believe we are going to need additional staff in the areas of compliance and monitoring that I have not even figured out yet."

The department reports 70,743 patients at the end of March, with just over 8,000 in Santa Fe County. The statewide total has spiked by 39% in the last year, and the rate of growth will only ramp up, predicts Ultra Health, which operates nearly two dozen dispensaries in the state.

"It's likely the Medical Cannabis Program will double in size over the next year," reads a newsletter issued last week by the company's communications manager, Marissa Novel.

The producer led the legal effort that overturned the state's plant cap rule and keeps the pressure on the state to increase the allowed supply. It warns that even with the court order, "any initial relief is not likely to come until July after the first plants under the temporary 2,500 cap have been harvested. Even then, supply levels will continue to be strained as more patients enroll in the program."

Later this month, the department expects to review the results of surveys issued to patients and producers. Kunkel hopes it will help managers address the concept of "adequate supply" and how to reframe rules to provide it.

She tells SFR she met with representatives from every licensed producer after getting the cabinet appointment, and says she's got other ideas about making the program work better after hearing from them. One thing they'll likely tackle is that producers, she says, "are not happy" with a computer system called BioTrackTHC, which the state implemented to keep records on product testing and sales.

Program Manager Kenny Vigil says through spokesman David Morgan that the program staff think BioTrackTHC "has strengthened the Medical Cannabis Program, as there is now a centralized system to report cultivation and sales." The program is, however, planning to implement an "upgraded system" to allow for patients to submit applications online.

Patient advocate Jason Barker followed the legislative process closely and has long been a participant in public processes overseen by the Medical Cannabis Program board. He tells SFR the outcome of the session wasn't overly wonderful.

"With the Medical Cannabis Program changes, if you compare the original version that was first filed to the final version, they did pretty much gut the bill and took out some of the most meaningful things that were very important to the patients," says Barker, who represents a group called Safe Access New Mexico.

Notably, he says, the Legislature didn't exempt sales from gross receipts taxes, agree to establish a patient and producers advisory board, or increase the number of plants an individual patient is allowed to grow at home. But some concepts that did see approval, such as the creation of social consumption areas and codification into law a personal growing program that had previously just been a rule, are positive.

"I guess, the patient community as a whole," he says, "we are all kind of waiting to see what is going to be done to benefit the patients."

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